F5 Welcome to F5 Medicine Information for patients, families and visitors Juravinski Hospital Section F Level 5 905-521-2100, ext. 43385 Being a patient or having a family member in the hospital can be very stressful. You will have new experiences and you may have questions. This booklet will help to answer some of your questions about your stay on F5 and help prepare you for leaving the hospital. If you would like more information or have any questions please feel free to ask any member of the health care team. We are here to help you.
Welcome to F5 Medicine Table of contents Page Welcome to F5 Medicine... 1 What happens when a patient is identified as ALC?... 2 How can family and friends help on F5?... 2 When can family and friends visit?... 3 What happens each day on F5?... 4 Who will be a part of my health care team?... 5 Sharing information with the health care team?... 8 About your care... 9 Getting enough nutrition... 11 Items you will need during your stay... 13 We are a smoke-free hospital... 14 Televisions, telephones and wireless... 15 Discharge day... 15 Getting around the Juravinski Hospital... 16 Parking... 16 Note to families and visitors... 17 Patient experience... 17 Information on ALC co-payment... 18
Welcome to F5 Medicine 1 Welcome to F5 On F5 we care for patients who have stable conditions and no longer need acute care services. However, these conditions cannot be managed at home. Our patients are waiting to be transferred to: complex continuing care a long-term care home (also known as a nursing home) a rehabilitation unit a retirement home or a convalescent or palliative care setting Patients may also be transferred to a temporary placement (also called a transitional placement) in a retirement home to await long-term care placement. Patients on F5 are identified by the term, Alternate Level of Care (ALC). While you are on F5, the team works together to manage your care and discharge plans. If your condition changes while on F5, you may be transferred to another care unit in the hospital. Your length of stay on F5 depends on your health care needs and goals.
2 Welcome to F5 Medicine What happens when a patient is identified as ALC? While in the hospital, some patients who are identified as ALC may have to pay a co-payment fee. The maximum co-payment is the same amount that is charged for basic accommodation in a long-term care home or complex continuing care setting. This fee covers the cost of your room and meals. Your health insurance (OHIP) will continue to pay the hospital for the services of your health care team. All patients waiting for a long-term care home or some complex continuing care settings will be charged a co-payment fee, even if they are still on an acute care unit of the hospital. The ALC co-payment fee is set by the Ministry of Health and Long-Term Care and changes yearly. You may pay all or some of this fee, depending on your income. More information about co-payment fee can be found at the end of this booklet on page 18. How can family and friends help on F5? Family and friends have an important role in giving you emotional support as you adjust to changes in your lifestyle. They can go with you to some therapies and learn how to help you. They can also attend meetings concerning your progress and help you return to the community. Family and friends can also help their loved ones by: taking them for short walks helping with their meals helping with personal care (bathing, eating, dressing or toileting) reading them a book, listening to music or talking about hobbies or things they enjoy doing
Welcome to F5 Medicine 3 When can family and friends visit? We have open visiting hours. This means that visitors are welcome at any time but patients and families decide what times are best for them. Please keep in mind that rest and sleep are important for all of our patients. You may need to shorten your visit if your loved one is tired and needs to rest. If you stay overnight, please remain in the patient s room and let the staff know when you arrive and when you leave the unit. Children are welcome, but must be with an adult at all times. All children must be current with their immunizations. Please allow the patient to get a good night s rest. We are committed to patient and family-centred care. We will do our best to be flexible, accessible and responsive to your needs. Visiting guidelines: All visitors must be in good health. Do not visit if you are sick. If there are more than 2 visitors, you can meet in the dining room located at the end of the first hallway. You can use our sunroom to socialize, watch television or use the computer. To help stop the spread of infection wash your hands using the alcohol-based hand rub located outside of each patient s room before and after each visit.
4 Welcome to F5 Medicine There may be times when you need to wear a gown, mask and gloves. When this is needed, we will place a sign on your door and your nurse will give you more information. Visitors may be asked to leave the room during certain medical procedures. Do not use the patient s bathroom. There is a visitor s bathroom located at the end of the second hallway. We are a fragrance restricted hospital. Do not wear or bring perfume, cologne, aftershave, scented hair spray or other scented products. Flowers, potted plants and latex balloons are not allowed on F5. You may bring in mylar foil balloons only. What happens each day on F5? Shift changes Our nursing team change shifts between 6:45 and 7:15 in the morning and evening. These are busy times on F5. During this time important information about your care is exchanged in the nursing station. If you need help right away during these times, one of our staff can help you.
Welcome to F5 Medicine 5 Rounds Every morning, the doctor and team assigned to your care meet to discuss your condition and care. Entering information into the computers You may notice staff using the computers. Members of the health care team enter important information about all aspects of your care into these computers. We try to do this at the same time we provide care, such as, taking your blood pressure, treating your wounds and tracking your progress. This allows the team members to have access to the most current information on your progress. Who will be a part of my health care team? There are many members on your team who work together to provide your care. You and your family are the most important members of the team. We want to know what is most important for you to become as independent as you can be. You, your family, and close friends, will work together with the team to set your treatment needs and goals. We encourage you to keep a list of questions to ask the heath care team. Please talk with any member of the team if you have any concerns during your stay with us.
6 Welcome to F5 Medicine Team member Business Clerk Chaplain Charge Nurse/Unit Leader Clinical Manager Community Care, LHIN Coordinator Environmental Aide (EA) Health Care Aide (HCA) Hospitalist Nurse Practitioner (NP) Occupational Therapist (OT) and Occupational Therapist Assistant (OTA) How they help Answers the telephone and provides clerical support to the team. Provides spiritual care to people of all faiths or arranges care by clergy in the community. In charge of the daily operations of the unit along with the health care team. Is available to discuss nursing care, hospital services or your needs and comfort. Manages the staff and the overall operations of the unit. Assesses your eligibility for home care. Helps with your discharge planning if home care is needed. Keeps our environment clean. Delivers your meals and helps set up your meal trays. Supports the team by assisting you with your personal care and other daily activities. The doctor in charge of your medical care on our unit. Works with the team to coordinate your medical care and discharge planning. Are Advanced Practice Nurses with additional medical training. Provides ongoing supportive and medical care including physical assessments, ordering laboratory and diagnostic testing, diagnosing medical conditions and prescribing medications to support your needs. Consults with the doctor on a regular basis to coordinate your health care needs. Assesses and recommends ways for you to safely do daily tasks such as dressing, bathing and toileting. Helps with concerns around equipment, home safety, or management of daily activities before you leave the hospital.
Welcome to F5 Medicine 7 Team member Who they can help Pharmacist Manages the medications ordered by your doctor or NP and prevents problems related to your medications. Is also available to teach you about your medications. Physiotherapist (PT) and Helps you become more independent with Physiotherapist Assistant physical activity. (PTA) Teaches you to use aids such as walker and cane. Helps you to improve your strength, flexibility, balance and coordination. Registered Dietitian (RD) and Dietetic Assistant (DA) Registered Practical Nurse (RPN) Social Worker Assesses, recommends and explains the need for all special diets. Ensures you meet your nutritional needs and helps you with your meal plan so you receive the foods that are best for you. The nurse assigned as your primary caregiver who is responsible for assessing and providing your health care needs such as hygiene, medication administration, nutritional intake. Reinforces and support the skills you have learned in rehabilitation therapies such as exercises and walking. Provides health teaching to you and your family. An RN may also be assigned as your primary caregiver. Arranges family meetings and discharge planning meetings as requested or needed. Helps you cope with your concerns and changes in your lifestyle. Is a great resource for services and supports that you may need when you leave the hospital.
8 Welcome to F5 Medicine Students Volunteers Team member How they help As a teaching hospital we provide training for student doctors, nurses, and other health care professionals. Each student works under the close supervision of a fully trained professional. Assist with the Hospital Elder Life Program (HELP) see more information on page 12. Note: The Hospitalist, NP, OT, OTA, PT, PTA, RD, DA and LHIN Coordinator are available Monday to Friday, during daytime working hours. Please speak to your assigned nurse or Charge Nurse if you wish to arrange a time to see the Hospitalist to discuss your medical needs. Sharing information with the health care team We ask that one person be chosen as the family spokesperson. The health care team will speak to this person who can pass information on to family and friends. Information over the phone will only be given to the spokesperson. The nurse may not always be available right away to speak with you. Your patience is appreciated when you call. The doctor will only give your information and test results to you and your family spokesperson or substitute decision-maker. Ask a staff member for a copy of Making Decisions for Others your role as a Substitute Decision Maker.
Welcome to F5 Medicine 9 About your care As patients on F5 have a stable condition and no longer need acute care services, you see a different staffing level on the unit compared to other areas of the hospital. Team meetings As part of your care, the health care team meets together daily during the week to discuss your progress and planning for your discharge from F5. Members of your health care team will work with you to help you develop your discharge plan. The team assigns each patient a discharge colour based on their discharge plan. You have no firm discharge plan. You are waiting for a response from programs and services. Your discharge plan is complete. Please let a member of your team know if you have any concerns to be brought up at this meeting. Your room We make every effort to provide you the type of room you requested and have insurance coverage for, but unfortunately this is not always possible. Patients are assigned to rooms based firstly on their medical needs. Sometimes, due to changing medical needs, patients may need to change rooms, despite having insurance coverage. Beside your bed, there is a table and a cabinet for your personal belongings. The bathroom in your room is for patients use only. There is an emergency call bell to use if you need a nurse urgently.
10 Welcome to F5 Medicine F5 C.A.R.E.s The C.A.R.E. (Comfort, Activity, Restroom, Environment) approach is used by our staff members before leaving your room. We use C.A.R.E. to ensure that your needs are met and addressed in a timely manner and to check your room for any hazards that can lead to falls. Personal care As part of your care, you will be expected to do as much of your daily personal care as possible. This is to help strengthen your muscles after being in bed with an illness. Daily exercise helps to increase blood flow as well as prevent blood clots from occurring. Please expect to have at least 1 to 2 showers a week. We do not have bathtubs. Skin care Lying in bed puts pressure on your skin. This pressure can lead to wounds or sores. The pressure may cause burning, redness or pain; especially around your ears, shoulders, elbows, buttocks, ankles and heels. If you have any of these signs, please tell your nurse or other health team member right away. The best way to prevent skin problems is to change positions often and avoid lying down in bed for long periods of time. Members of your health team will encourage you to get up and move as much as possible. Eating and drinking well also supports healthy skin. For more information on skin care, please ask for a copy of the handout, Keeping your skin healthy and free of pressure ulcers or visit the Patient Education Library on our website www.hamiltonhealthsciences.
Welcome to F5 Medicine 11 Getting enough nutrition Eating right and getting enough nutrition in hospital could be a challenge as you may: have a decreased appetite find the foods different from what you normally eat at home. Getting enough nutrition helps reduce complications such as pressure ulcers and infections, and it helps maintain your muscles. This can help you to do the activities you enjoy. Please tell our staff if you have any special diet needs, such as food allergies or intolerances, difficulties chewing or swallowing, or think you may need a nutritional supplement drink. Meal times Breakfast: Lunch: Supper: 8:00 am to 8:30 am 12:00 pm to 12:30 pm 5:00 pm to 5:30 pm Menus to select your meals are delivered daily on your dinner tray and will be picked up at the bedside with your breakfast tray by 9:00 am. The meals you choose tonight are for the day after tomorrow. Let your nurse know if you prefer to mark your menus for a whole week in advance. We encourage family and friends to help mark menus and help the patient at meal times. Family and friends can bring in foods from home if desired. Please check with your nurse first to make sure that these foods are right for your diet. If you have any questions or concerns about your diet, ask to speak with a registered dietitian.
12 Welcome to F5 Medicine Dining/Activity Room You may prefer to have your meals with other people staying on F5 in the dining/activity room. You may also use this room for activities such as to play games or watch TV with your visitors. Hospital Elder Life Program (HELP) When an older person becomes ill and goes into hospital, there is an increased risk of developing delirium. Delirium is a sudden confused state of mind. It may occur during an illness or after an operation. The Hospital Elder Life Program (HELP) is a delirium prevention program offered to patients on F5 and many other units at the Juravinski Hospital. Through the use of trained volunteers, HELP aims to prevent this new confusion and assist patients with simple but important tasks throughout their hospital stay. HELP volunteers visit patients a few times a day to assist with: Regular orientation to the date, time and location. Vision and hearing problems. For example, making sure glasses are on and clean, and hearing aids are in and working. Hearing amplifiers and magnifiers are also available if needed. Selecting menus, setting up meals and encouragement. Simple exercises. Providing stimulating activities and social visits. HELP volunteers also run a group a few times a week. Longer stay patients come together to get time out of their rooms and take part in fun and engaging activities. This group setting is aimed to improve orientation, socialization, and basic mobility. We invite you to join us!
Welcome to F5 Medicine 13 Items you will need during your stay Bring in personal items such as: toothpaste, soap, shampoo, lotion and deodorant eye glasses, hearing aids (with extra batteries), and dentures You can also bring any items that comfort you, such as: a special pillow and blanket pictures or music players Put your name on all these items and send items home that you do not need. Do not leave any valuables unattended, such as money, cell phone or electronic devices. The hospital is not responsible for lost or stolen items. Leave items of value at home such as jewellery and wallets. Clothing and shoes Every morning, you will need to get up, get dressed and remain dressed all day. Wearing loose fitted, comfortable clothing will make your therapy easier. There are no washing machines on the unit so clothes need to be taken home to be washed. For your safety, you must always wear non-slip footwear. You may need a special kind of shoe. Please check with your therapist before buying new shoes.
14 Welcome to F5 Medicine Electrical appliances All electrical appliances such as blow dryers and shavers must be checked for their safety by the Engineering/Maintenance Department. Please give any such items to your nurse. Curling irons are not allowed. Money Leave large amounts of money at home. Please keep only small amounts with you. Medications Bring in the medications you take regularly in their original containers. This includes prescription and over-the-counter medications, vitamins, and herbal products. After the nurse, pharmacist, nurse practitioner or doctor reviews your medications with you, please send them home. While you are in the hospital, the health care team will order your medications, and the nurse will give you the medications that you should take. Do not take your own medications. We are a smoke-free hospital Smoking is not allowed anywhere on the hospital grounds, including parking lots, garages and vehicles. We appreciate your co-operation in providing a safe and healthy environment for everyone. For support or help to stay smoke-free: Talk to your health care provider Call Smokers Helpline at 1-877-513-5333 or visit www.smokershelpline.ca
Welcome to F5 Medicine 15 Television, telephones, and wireless Bedside TV and telephone are available to rent and can be activated at any time. For instructions, obtain an information card located beside the nursing station across from Room 14. Follow the instructions on the card using the patient s bedside telephone. Call ext. 41234 and follow the easy instructions to activate services. You will need to use a credit card for using the automated phone connection. Additional payment forms are available, and are listed on the instruction card. Cable TV is available in the F5 dining room. Cell phones may be used. Pay phones are located at the entrance of F5. Wireless service is available for a fee. For more information ask your nurse or visit www.hhsc.ca/hotspots Discharge day You will be given the date of when you can leave the hospital, called your discharge day, ahead of time. Talk to a member of the health care team the day before to confirm this date and make sure you have all of your prescriptions and follow-up appointments booked. Before your discharge day, you will need to: pack your belongings the night before. arrange for a ride home from the hospital. If you are not able to arrange for a ride home, the health care team will help you to arrange another source. There are a variety of options. Discharge time is 9:00 am. You may need to wait in the dining room for your ride so that we can prepare the room for the next patient.
16 Welcome to F5 Medicine Getting around the Juravinksi Hospital The Chapel/Spiritual Centre is located in the Main Lobby, Level 1, beside the gift shop. The centre is open 24 hours a day for meditation, prayer and personal reflection. The Gift Shop is located in the Main Lobby, Section A, Level 1. Vending machines are located in the corridor beside the passenger elevators in Section C, Level 1. The Atrium Café is located in Section G, Level 1. The cafeteria, Nora s Fresh Café is in Section A, Level 0. Information is located in the Main Lobby, Level 1. Ask a social worker, nurse or business clerk for a list of local hotels or information about the Mark Preece House if you are from out of town. There are a number of restaurants located on Concession Street that are within walking distance from the hospital. Parking There is a parking garage across the street from the hospital s main entrance. There is an hourly rate for parking with a daily maximum. If visitors plan to leave and re-enter the garage during the day, or will be coming to the hospital frequently, parking pass options are available. For more information call ext. 42354 or visit the Parking Office, located on the lower level of the parking garage to discuss parking options. Weekly or monthly parking passes are available for purchase. The streets around the hospital have parking meters for 1 to 2 hours of parking.
Welcome to F5 Medicine 17 A note to families and visitors We understand that families feel a lot of stress when a loved one is in the hospital. We will do our best to help you cope. To help us focus on patient care, we trust that families, visitors and staff treat each other with respect. Respect is important when challenges are experienced. Our staff follows a Code of Conduct based on values such as caring and respect. A mutual respect booklet is available for patients and families. If you would like a copy, please ask a staff member. Reading this booklet will help you know how you and your family can communicate more effectively. The F5 Clinical Manager is available Monday to Friday, during working hours at 905-521-2100, ext. 43381. Patient experience If you have concerns about your loved one s care or would like to share a compliment, please speak with a member of the health care team or call the office of Patient Experience at 905-521-2100, ext. 75240 or email patientexperience@hhsc.ca. Notes please turn over
18 Welcome to F5 Medicine Information on ALC co-payment Call our Co-Payment Specialist at 905-521-2100, ext. 12411 to book an appointment right away to discuss your co-payment fee. At this appointment, the Co-Payment Specialist can help you or your family to fill out the Co-Payment Calculation form. This form determines your co-payment fee. The fee may be reduced depending on the financial or family situation. You will need to have a copy of your last income tax return at this appointment to determine your fee. The Co-Payment Calculation form must be filled out and returned within 2 weeks. If the form is not returned within 2 weeks, the hospital must charge the full rate. When does the co-payment fee start? Co-payment starts when you no longer need the acute care services or a hospital and the team has determined you need to wait for a bed in a long-term care home or complex continuing care setting. What happens if my condition changes? If your condition changes and you need acute care again, the change will be made in your health record. You will not be billed for the days you need acute care. Where can I get more information? If you have questions or concerns, please speak with a social worker. Visit the Ministry of Health and Long-Term Care website at www.health.gov.on.ca/ and search for chronic care co-payment. Hamilton Health Sciences, 2010 PD 7132 01/2016 dpc/pted/f5alcmedicinewelcome-trh.docx dt/january 11, 2016